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CONCLUSIONS Protamine may be properly used in TCAR to reduce the possibility of perioperative bleeding complications without increasing the risk of thrombotic events. UNBIASED An analysis ended up being carried out of very early and midterm results of a big group of patients addressed with in situ laser fenestration (ISLF) during thoracic endovascular aortic restoration (TEVAR) of intense and subacute complex aortic arch diseases, such as for example Stanford type A aortic dissection (TAAD), type